title: Spontaneous pneumothorax with persistent air leakage and invasive procedures.
abstract: OBJECTIVE
  Prolonged air leaks in patients with spontaneous pneumothorax are not infrequent. The aim of this study was to assess the duration of air leaks and define the clinical variables associated with the therapeutic success of chest tube drainage for spontaneous pneumothorax.
  
  
  METHODS
  A total of 441 patients with spontaneous pneumothorax treated with chest tube drainage between 2008 and 2012 were retrospectively evaluated. The clinical differences between the patients successfully treated with drainage and those who required more invasive procedures were analyzed.
  
  
  RESULTS
  Invasive procedures, such as video-assisted thoracic surgery (n=121), fibrin glue administration through a chest tube (n=8) and pleurodesis with OK-432 (n=21), were performed in 34% (150/441) of the patients. The treatment rate of chest drainage alone was higher in the patients with initial pneumothorax (72%; 124/170) than in those with recurrent pneumothorax (62%; 167/271) (p=0.015). In addition, this rate was higher in the patients with moderate lung collapse (70%; 167/237) than in those with severe lung collapse (61%; 124/204) (p=0.032).
  
  
  CONCLUSIONS
  Patients with recurrent pneumothorax or severe lung collapse associated with prolonged air leakage are more likely to receive invasive procedures.
authors.affiliation: Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Haga
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kurihara
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kataoka
mesh_terms: D000328:Adult; D015505:Chest Tubes / Q000706:statistics & numerical data; D004322:Drainage / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018700:Pleurodesis / Q000379:methods* / Q000706:statistics & numerical data; D011030:Pneumothorax / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult